45751 (2) 6790 John
CITY OF SAN JOSE �,p �SBUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
'
Date/-P. -. .. .�' . ,.........195---------- Permit No..........
The undersigned he b a plicationjo-the.PI mbing Inspector of the City of
San Jose for a perrn�rt rm}�al iif�pgences/and%or gas pipes as listed on the
reverse side hereof, and egfees to install said appliances end/or pipes in accordance
with the provisions of Article VIII, Ch�t4, of e.5gn,JoseeMunicipal Code, and
other laws applicable
thereto. 7
OWNER . /.----L-- `¢` / ?..C1 �� -� ?>S_
ADDRESS ?' -VO -21...../�/ .J--4•-----.--•--------•-----------
USE OF BUILDING _.... i I ----
romMW Signe ....--�.... .- .—
6790 John
Type of Appliance No. Remarks (Check V(
New Re lace Relocate
Gas Ranges
_Wall Heaters
Gas Plates
-
Circulating Heaters
Blower Furnaces
_Gas Fired Boilers
Warming Ovens
Percolafors
Griddles
Steam
Tables
Gravity Furnaces
5us ended Unit
Floor Furnace
Miscellaneous
Nemo T p*
TOTAL
FEE
Inspected and Approved By
HOUSE GAS PIPING
Number of OutletsSize of Main
FEE
Tested and Approved//_/?-�T By